Ophthalmology, New York Eye and Ear Infirmary, New York, NY 10003, USA.
Am J Ophthalmol. 2013 Mar;155(3):585-592.e2. doi: 10.1016/j.ajo.2012.09.030. Epub 2012 Dec 4.
To describe the clinical and pathologic characteristics of mucin-producing sweat gland carcinoma of the eyelid and to determine whether neuroendocrine differentiation is of prognostic significance.
Retrospective interventional case series.
Search of the New York Eye and Ear Infirmary pathology database between 1990 and 2011 identified 16 patients with mucin-producing sweat gland carcinoma. Clinical, histopathologic, and immunohistochemical analyses were performed on all identified cases.
The patients presented with vascularized, focally cystic, nonulcerated eyelid margin lesions. Histopathologic evaluation showed that 4 lesions (25%) had a cystic, papillary, and solid growth pattern with an in situ component, 7 (44%) were pure invasive mucinous carcinomas, and 5 (31%) demonstrated both growth patterns. Immunohistochemical analysis of 15 tumors showed that pure cystic/papillary lesions had a significantly greater percentage of synaptophysin-immunoreactive cells (P = .036). There was no significant difference in the number of neuroendocrine markers expressed or in the intensity of immunostaining among the 3 different growth patterns. Re-excision for margin clearance was performed in 8 of 13 cases (61.5%). Two of 13 lesions recurred (15%); 1 of these was an in situ tumor with cystic morphology and neuroendocrine differentiation and the other was pure invasive mucinous carcinoma. None of the lesions metastasized.
Mucin-producing sweat gland carcinoma pathologically represents a continuum, from an in situ lesion to a classic, invasive mucinous carcinoma. Immunohistochemical evidence of neuroendocrine differentiation can be observed in all lesions and does not appear to have a prognostic significance, arguing against the utility of immunohistochemical subtyping of mucinous sweat gland carcinomas.
描述眼睑黏液产生性汗腺癌的临床和病理特征，并确定神经内分泌分化是否具有预后意义。
回顾性干预性病例系列研究。
在 1990 年至 2011 年间，通过纽约眼耳保健院的病理数据库搜索，确定了 16 例黏液产生性汗腺癌患者。对所有确诊病例进行临床、组织病理学和免疫组织化学分析。
患者表现为血管丰富、局灶性囊性、非溃疡性的眼睑缘病变。组织病理学评估显示，4 例（25%）病变呈囊性、乳头状和实性生长模式，伴有原位成分；7 例（44%）为单纯浸润性黏液癌；5 例（31%）表现出两种生长模式。对 15 例肿瘤的免疫组织化学分析显示，单纯囊性/乳头状病变中突触素免疫反应性细胞的比例明显更高（P=0.036）。在 3 种不同生长模式中，神经内分泌标志物表达的数量或免疫染色强度均无显著差异。在 13 例中有 8 例（61.5%）进行了边缘清除的再次切除。13 例中有 2 例复发（15%）；其中 1 例为原位肿瘤，具有囊性形态和神经内分泌分化，另 1 例为单纯浸润性黏液癌。无病变转移。
黏液产生性汗腺癌在病理上代表一个连续体，从原位病变到经典的浸润性黏液癌。所有病变均可观察到神经内分泌分化的免疫组织化学证据，且似乎无预后意义，这表明黏液汗腺癌的免疫组织化学亚型分类并无实际应用价值。
